Real-world effectiveness of a German school-based intervention for primary prevention of anorexia nervosa in preadolescent girls.

Abstract

Anorexia nervosa ('AN') is notoriously difficult to treat, has high mortality rates, and has a prevalence peak in 15-year-old girls. We developed a German school-based intervention program ('PriMa') for the primary prevention of AN in preadolescent girls and assessed the effects in a sample of Thuringian girls. Intervention involved nine guided lessons with special posters and group discussions. A parallel controlled trial with pre-post measurements and a three-month follow-up was conducted in 92 Thuringian schools (n=1553 girls) in 2007 and 2008. Primary outcomes were conspicuous eating behavior, body self esteem, and AN-related knowledge. After adjusting for the girls' ages and the type of school, we observed significant improvements in the areas of knowledge (d=.24) and body self esteem (d=.29), but not for eating behavior. The PriMa intervention provides an efficient and practical model to increase AN-related protection factors.